MEDICARE: DR. MICHAEL HARRY DUKELOW M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	13296	HI

General Provider Information

NPI Number	:	1861486417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL HARRY DUKELOW M.D.

Provider Business Mailing Address
First Line	:	2420 KALAKAUA AVE
Second Line	:	STE 401
City	:	HONOLULU
State	:	HI
Zip	:	96815-6209
Country	:	US
Telephone Number	:	402-614-1016
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 KALAKAUA AVE
Second Line	:	STE 401
City	:	HONOLULU
State	:	HI
Zip	:	96815-6209
Country	:	US
Telephone Number	:	808-922-6000
Fax Number	:	808-922-2680

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	01/23/2018

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